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Sloober posted:The article says consulting firms used by dems are being paid by health interest lobbyists to work against it, notably insurance companies. Read the article before you react. No worries guys, it's only Democratic firms assisting among the largest contributors to Democrats. Nothing to see here.
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Mar 20, 2017 15:22
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call to action posted:No worries guys, it's only Democratic firms assisting among the largest contributors to Democrats. Nothing to see here. Paid democratic-aligned political firms getting paid to lobby Democrats is not surprising and you are stupid to attribute it to "The Democrats".
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Mar 20, 2017 15:28
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What will happen with the amendment process and house vote is now pretty clear. Ryan has made the calculation that the Freedom Caucus is bluffing but the moderates are not, and so he's going to give only token wins to the conservatives (to give them some cover for capitulating) and then try to force through the vote by daring them to vote against repeal. The amendment process may move the bill to the left, given his abrupt realization that old people vote (and usually, vote Republican) and that sticking them with enormous premium increases is about as dumb politics as you can get. However, at least three moderates are still planning on voting against it, but the moderates have been relatively quiet about their concerns so far (which makes sense, given the politics of the issue: they want to get their changes quietly and not announce to the far right they need to be primaried). The Freedom Caucus says they've still got the votes to block it. One of those two groups is wrong. Honestly, neither of them may be lying: if either side shows weakness its members will start defecting because many people don't want to be on the wrong side of this vote.
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Mar 20, 2017 15:44
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What are you basing that on? I've seen a few articles recently that indicate they're moving to the right with it to appease the conservatives. Edit: this article for example http://www.cnn.com/2017/03/19/politics/trump-health-care-senate/index.html HappyHippo fucked around with this message at 15:49 on Mar 20, 2017 |
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Mar 20, 2017 15:46
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HappyHippo posted:What are you basing that on? I've seen a few articles recently that indicate they're moving right with it to appease the conservatives. http://www.politico.com/story/2017/03/paul-ryan-obamacare-repeal-trump-236229 quote:On several occasions, Trump — more used to business negotiations than political maneuvering — appeared to leave the door open to more sweeping changes to the bill sought by conservatives. Among their asks: rolling back the Medicaid expansion more quickly, or instituting more stringent work requirements for Medicaid recipients than House leadership wanted. It matches everything else that's being reported (like making the bill help seniors more: https://www.washingtonpost.com/powe...m=.29f5ead6b664) Conservatives will get some changes so they can "win", but they won't get the changes they want that would threaten moderate support, such as early Medicaid sunsetting.
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Mar 20, 2017 15:50
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HappyHippo posted:Edit: this article for example http://www.cnn.com/2017/03/19/politics/trump-health-care-senate/index.html I think the difference here is what articles say Trump will do. Trump is a wild card and most of the leaks saying what he will do are from one faction of his admin trying to get him to do that. I don't believe - like Ryan wants him to do - he's going to put it all on the line behind the Ryan bill. He wants to leave himself an out if it fails. But I think it's pretty clear Ryan has the temperature of his moderate wing and knows they are a real risk of defecting - because they're the ones who will face getting voted out, not the freedom caucus - and knows he can't afford to lose them in the House. That's a political reality no amount of theatrics will get around, but theatrics are the freedom caucus's stock in trade so he can try to get around them with theatrics.
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Mar 20, 2017 15:54
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Right, I guess it all depends on what those concessions are, and if the changes to placate the moderates will push the conservatives away again. The real right wing isn't the Republican Study Committee though, it's the Freedom Caucus, they could block it themselves couldn't they?
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Mar 20, 2017 16:01
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HappyHippo posted:Right, I guess it all depends on what those concessions are, and if the changes to placate the moderates will push the conservatives away again. Yes. Ryan's goal is for the Freedom Caucus to be standing alone in opposition to the bill on Thursday and deciding if they reeeeeeeeeeeally want to be in that position without any other allies.
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Mar 20, 2017 16:04
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The Hill's whip count thing has been updated with 'yes' votes. http://thehill.com/homenews/house/322903-the-hills-whip-list-where-republicans-stand-on-obamacare-repeal-plan
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Mar 20, 2017 19:38
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Amused to Death posted:This seems like the exeception. No one i know truly knows what their current work health insurance costs. I asked when i found out mine, and i only did that by accident. I checked in some tax document I received and I really think that many employees not realizing how much this stuff actually costs (as asdf mentioned) is a big barrier to discussions on the topic. I pay something between 100-200 a month, but my employer pays like 700-800 dollars or something IIRC. The problem is that people see the fact that universal healthcare would increase their taxes and either compare that against how much they're personally paying now or, even worse, fail to even consider the fact that their existing health insurance expenses would disappear under a universal system paid for by taxes.
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Mar 20, 2017 20:35
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Ytlaya posted:I checked in some tax document I received and I really think that many employees not realizing how much this stuff actually costs (as asdf mentioned) is a big barrier to discussions on the topic. I pay something between 100-200 a month, but my employer pays like 700-800 dollars or something IIRC. The problem is that people see the fact that universal healthcare would increase their taxes and either compare that against how much they're personally paying now or, even worse, fail to even consider the fact that their existing health insurance expenses would disappear under a universal system paid for by taxes. I'm not sure they are entirely wrong. If UHC got passed, I can't see employers saying "Since we don't need to pay for your healthcare any more, here's a $1,000 a month pay rise."
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Mar 20, 2017 20:40
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BarbarianElephant posted:I'm not sure they are entirely wrong. If UHC got passed, I can't see employers saying "Since we don't need to pay for your healthcare any more, here's a $1,000 a month pay rise." I think the idea is that all of the money spent on current insurance policies could fund UHC, and just outright cover everyone with less complexity than the current system. So instead of a pay raise or higher taxes, the same money that's already being spent now would be spent elsewhere.
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Mar 20, 2017 20:50
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Twerk from Home posted:I think the idea is that all of the money spent on current insurance policies could fund UHC, and just outright cover everyone with less complexity than the current system. So instead of a pay raise or higher taxes, the same money that's already being spent now would be spent elsewhere. Ah, but this argument assumes that helping others is something Americans care about. I think most Americans would see it as "I lose a perk so some rear end in a top hat and his kids get covered". Also, don't we spend more public money on healthcare, per capita, than any other nation on earth? Why couldn't we just use that pool of money and not reallocate premiums to taxes?
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Mar 20, 2017 20:52
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Twerk from Home posted:I think the idea is that all of the money spent on current insurance policies could fund UHC, and just outright cover everyone with less complexity than the current system. So instead of a pay raise or higher taxes, the same money that's already being spent now would be spent elsewhere. It can't unfortunately. The amount of solvable inefficiency in the system is less than the amount of additional care that would be demanded. There are still millions without insurance and millions more who forgo or reduce treatment due to cost.
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Mar 20, 2017 20:53
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Xae posted:It can't unfortunately. The amount of solvable inefficiency in the system is less than the amount of additional care that would be demanded. This is such horseshit, we pay so much more for healthcare in per capita dollars both publicly and privately than any other country and yet, for some reason, "the amount of money we pay today can't fund UHC". Horseshit, bullshit, nonsense.
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Mar 20, 2017 20:55
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Twerk from Home posted:I think the idea is that all of the money spent on current insurance policies could fund UHC, and just outright cover everyone with less complexity than the current system. So instead of a pay raise or higher taxes, the same money that's already being spent now would be spent elsewhere. Lets say that currently you pay $200 a month towards your work healthcare and your employer adds $1,000 to that. UHC gets introduced, funded by a tax that works out as $500 a month for you. So you stop paying $200 and now must pay $500. Your employer stops paying $1000 but doesn't give you anything in compensation. Yes, that's stupid. But why wouldn't it happen?
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Mar 20, 2017 20:57
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BarbarianElephant posted:I'm not sure they are entirely wrong. If UHC got passed, I can't see employers saying "Since we don't need to pay for your healthcare any more, here's a $1,000 a month pay rise." Ok? Uncoupling health insurance from employment allows people to innovate or change jobs without supreme anxiety. It allows people to open businesses without being crippled with employer health costs, or risk bankruptcy themselves if they can't afford their own insurance. It allows people mobility and releases us all from the low-level dread of the reality that we are an accident away from destitution. There is no down side to UHC. It is cheaper than our current system. It increases access. It improves outcomes. It minimizes human suffering and economic anxiety. Basically all things the GOP wants to avoid because they want us to be slaves to our employers and to insurers.
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Mar 20, 2017 20:57
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call to action posted:This is such horseshit, we pay so much more for healthcare in per capita dollars both publicly and privately than any other country and yet, for some reason, "the amount of money we pay today can't fund UHC". Horseshit, bullshit, nonsense. We can't do it without putting the senators' leash holders out of business, so they need an excuse. Some combination of "we can't afford it" and "OMG SOCIALISM" has pretty much gotten the plebs on board
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Mar 20, 2017 21:00
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LeeMajors posted:Ok? He's not saying UHC is bad, but that people are stupid and could be easily made to believe that they are losing a benefit and seeing nothing in return.
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Mar 20, 2017 20:59
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BarbarianElephant posted:Lets say that currently you pay $200 a month towards your work healthcare and your employer adds $1,000 to that. UHC gets introduced, funded by a tax that works out as $500 a month for you. So you stop paying $200 and now must pay $500. Your employer stops paying $1000 but doesn't give you anything in compensation. Yes, that's stupid. But why wouldn't it happen? We already have payroll taxes that are jointly paid by employer and employee, and as recently as a couple years ago the employer's share of payroll taxes has been larger than employee. Why not fund it via 80/20 employer / employee taxes?
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Mar 20, 2017 21:00
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LeeMajors posted:Ok? Hey, I support it 100%. I'm just pointing out why employed people who aren't too bright might not like the idea of it.
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Mar 20, 2017 21:00
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call to action posted:This is such horseshit, we pay so much more for healthcare in per capita dollars both publicly and privately than any other country and yet, for some reason, "the amount of money we pay today can't fund UHC". Horseshit, bullshit, nonsense. Reality doesn't give a gently caress what names you call it. Maybe you should start looking into why we pay so much more.
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Mar 20, 2017 21:00
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BarbarianElephant posted:I'm not sure they are entirely wrong. If UHC got passed, I can't see employers saying "Since we don't need to pay for your healthcare any more, here's a $1,000 a month pay rise." Yeah, but there's the option of increasing taxes on businesses for roughly the amount they would otherwise pay on health insurance (though in reality you'd probably be able to get away with taxing them for less than that, since a universal system would probably lower per capita costs). I mean, it might still end up costing people with particularly good employer plans a little more, but given the tax should be progressive to begin with that shouldn't have a big impact on anyone who doesn't already have more than enough money to afford the tax increase.
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Mar 20, 2017 21:02
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Badger of Basra posted:He's not saying UHC is bad, but that people are stupid and could be easily made to believe that they are losing a benefit and seeing nothing in return. Gotcha. I guess I misunderstood that piece of it--but even if that were the case, the benefits far outweigh that minor down side. I don't think anyone expects employers to give everyone a raise to meet that total compensation including health insurance premiums. I sure as hell wouldn't.
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Mar 20, 2017 21:03
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Xae posted:Reality doesn't give a gently caress what names you call it. Hmm, reality. You mean that reality that shows that every other country on earth has more efficient care than ours? Literally every other single country on earth? Actually, I take it back, I think Haiti might be lower on that scale, so point to you. I've already looked into the reason we pay so much more: because we let so many assholes profit off the care of the sick. Other countries don't allow that, which is reflected in their lower infant mortality, longer life expectancies, and lower cost to both the public and private. LeeMajors posted:Basically all things the GOP wants to avoid because they want us to be slaves to our employers and to insurers. I think healthcare is the most radicalizing issue of our time. Take an issue like climate change, or racism, or abortion. Do we know how to solve any of those issues? Maybe, to an extent, but there are definitely multiple valid viewpoints, even if I don't personally agree with them. UHC is different - the problem is solved has been solved for decades elsewhere, the only reason we don't reform is because we care more about enriching insurers, hospitals, doctors, pharma, and medical device manufacturers more than we care about the health of the American public. That's it, literally the only reason.
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Mar 20, 2017 21:06
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Ytlaya posted:Yeah, but there's the option of increasing taxes on businesses for roughly the amount they would otherwise pay on health insurance (though in reality you'd probably be able to get away with taxing them for less than that, since a universal system would probably lower per capita costs). You want to fund it through a direct tax. Part of the reason why SS and Medicare are so popular and hard to cut is because people see the money coming out of their paycheck. It isn't an "entitlement" anymore it is a something they fuckin' paid for and gently caress the person who tries to take it away from them.
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Mar 20, 2017 21:06
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Ytlaya posted:Yeah, but there's the option of increasing taxes on businesses for roughly the amount they would otherwise pay on health insurance (though in reality you'd probably be able to get away with taxing them for less than that, since a universal system would probably lower per capita costs). You know how scumbucket fast food companies added an "Obamacare surcharge" to food prices because they were forced to give their employees health insurance? Here's how it would go for an employee of RepublicanOwnedCorp: "Thanks for attending this meeting. Now, I'm sure you've heard a lot about Universal Healthcare. If you take a look at your paychecks next month you will see that you no longer have to pay the $200 for healthcare that was the cost of the company plan. Now, nothing in this life is free, despite what Democrats might tell you. UHC is paid for by taxes. So you will see a new $500 UHC tax subtracted from your paycheck. In effect, you are paying $300 to subsidize the poor and indigent. Maybe this makes you feel good. If not, please call your representative. His number is on the leaflets that Janine will be passing round after the meeting."
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Mar 20, 2017 21:11
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call to action posted:Hmm, reality. You mean that reality that shows that every other country on earth has more efficient care than ours? Literally every other single country on earth? Actually, I take it back, I think Haiti might be lower on that scale, so point to you. Wow I'm glad to hear you've got it all figured out! So can you tell me your thoughts on the usage rates of radiological imaging in the US when compared to the overall OECD average? Do you think the switch over to ICD10 will even out the epidemiological differences between the US and other Western nations? Care to share your thoughts on HL7 and any expected changes? In other words: gently caress off with your stupid simplistic bullshit. If the solution was so goddamn simple it would have been solved already. Or as even Trump found out healthcare is complicated! Since he found that out a couple a weeks before you that makes him smarter than you. Stop and think on that for a minute.
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Mar 20, 2017 21:16
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Xae posted:If the solution was so goddamn simple it would have been solved already. Isn't the point being made that, given that every other first-world country generally has UHC in some form, this problem actually was solved? I mean if you need a reductio ad absurdum solution to the original question, America pays more because there's gotta be profit in the health care industry somewhere.
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Mar 20, 2017 21:30
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Zamujasa posted:Isn't the point being made that, given that every other first-world country generally has UHC in some form, this problem actually was solved? Because other countries have UHC and profit speaking. Single Payer is popular in the anglosphere but rare outside of it. And because in the US there are states that ban profit speaking in some or most of healthcare. And those states aren't in any better situation than the states that allow for-profit. Profit isn't the differentiating factor. Systems don't get hosed up because one thing is wrong. Systems get hosed up because multiple points in the system are hosed up. And addressing one point of possible failure in system doesn't fix it. There is a ton of factors. Profit maybe a part of it but pretending like it is the sole problem is childish thinking. At best.
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Mar 20, 2017 21:36
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UHC countries tend to spend less on drugs, because larger purchasers can negotiate better prices. UHC countries tend to spend much less on administrative overhead, because everyone being covered under the same system simplifies administration.
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Mar 20, 2017 21:45
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One thing that has always struck me as weird is that the left in the US is so narrowly focused on single payer to the exclusion of other models. Lots of countries are not strictly speaking single payer UHC but their systems work well, and some would probably argue better than Canada or the UK. It kinda reminds me how people in Seattle were stuck for years and years on the idea of monorails, to the exclusion of all other grade-separated rail, for expanding public transit.
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Mar 20, 2017 21:47
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call to action posted:Ah, but this argument assumes that helping others is something Americans care about. I think most Americans would see it as "I lose a perk so some rear end in a top hat and his kids get covered". What do you think it's called when the government allocates part of your paycheck to a spending program?
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Mar 20, 2017 22:00
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SousaphoneColossus posted:One thing that has always struck me as weird is that the left in the US is so narrowly focused on single payer to the exclusion of other models. Lots of countries are not strictly speaking single payer UHC but their systems work well, and some would probably argue better than Canada or the UK. I don't get it either. A German style Public/Private hybrid system is workable in the US without a huge amount of work. Meanwhile there is huge efforts that amount to tilting at windmills from the left and the right. I've begun to wonder if it is less about providing care than it is about signalling that you're the "right type of person" who holds the Correct Beliefs(tm).
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Mar 20, 2017 22:04
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Xae posted:I don't get it either. I see a larger risk in a public/private hybrid system for the states to gently caress things up. I'd be thrilled if we had Obamacare with full 50-state medicaid expansion, but instead we have a situation where a Texas family with $5k in income last year makes too much money to qualify for Medicaid and too little money to get any ACA subsidies.
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Mar 20, 2017 22:07
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SousaphoneColossus posted:One thing that has always struck me as weird is that the left in the US is so narrowly focused on single payer to the exclusion of other models. Lots of countries are not strictly speaking single payer UHC but their systems work well, and some would probably argue better than Canada or the UK. UHC is probably the best "if you could imagine your ideal setup, what would it be" answer. Other answers generally rely on grappling with the reality of what you can get done in politics and what is a workable step forward from the current reality. A lot of people (on both sides, to be fair) tend to ignore that aspect of the problem. Hell, a lot of people attacked Obamacare from the left precisely because it dealt with those realities (and are now attacking its repeal from the right, same reason).
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Mar 20, 2017 22:10
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SousaphoneColossus posted:One thing that has always struck me as weird is that the left in the US is so narrowly focused on single payer to the exclusion of other models. Lots of countries are not strictly speaking single payer UHC but their systems work well, and some would probably argue better than Canada or the UK. I can agree with that and one of the problems I see in healthcare debates is that its so focused on "who pays?" rather than focusing on why healthcare costs so much in America. We spend the most per capita and get the least benefit, in fact we spend far and away more than other developed countries.  
Confounding Factor fucked around with this message at 22:12 on Mar 20, 2017 |
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Mar 20, 2017 22:09
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Twerk from Home posted:I see a larger risk in a public/private hybrid system for the states to gently caress things up. I'd be thrilled if we had Obamacare with full 50-state medicaid expansion, but instead we have a situation where a Texas family with $5k in income last year makes too much money to qualify for Medicaid and too little money to get any ACA subsidies. To be fair, that problem didn't exist in Obamacare: it was created by the Supreme Court. Expanding medicare was not really optional in Obamacare as written.
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Mar 20, 2017 22:11
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Twerk from Home posted:I see a larger risk in a public/private hybrid system for the states to gently caress things up. I'd be thrilled if we had Obamacare with full 50-state medicaid expansion, but instead we have a situation where a Texas family with $5k in income last year makes too much money to qualify for Medicaid and too little money to get any ACA subsidies. States gently caress everything up and I personally would Federalize about 90% of government and turn states into Administrative Regions if I could wave a magic wand and do it. Its a huge problems to be sure. But look at the Medicaid expansion. The states that didn't do it are coming around to it. I think there would be a similar situation where some states are raging assholes for a few years then finally get with the program.
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Mar 20, 2017 22:12
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Confounding Factor posted:I can agree with that and one of the problems I see in healthcare debates is that its so focused on "who pays?" rather than focusing on why healthcare costs so much in America. We spend the most per capita and get the least benefit, in fact we spend far and away more than other developed countries.  Obamacare attacked that problem as well! One of its major goals was to "bend the cost curve", adjusting the incentives in the medical system to encourage better and more efficient results.
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Mar 20, 2017 22:12
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